LEVEL 3 RN ATI COMPREHENSIVE PREDICTOR
EXIT ASSESSMENT 2026 | 180 EXAM QUESTIONS
WITH VERIFIED ANSWERS | FULL RN CONTENT
BREAKDOWN & RATIONALES | ATI NCLEX PREP
PACKAGE
SECTION 1: MANAGEMENT OF CARE & SAFETY
Q1. A nurse receives report on four clients. Which client should be assessed first?
A. Client with diabetes mellitus, blood glucose 55 mg/dL, diaphoretic
B. Client with heart failure, 2+ pitting edema, crackles in lung bases
C. Client post-operative day 1 reporting pain 6/10
D. Client with seizure history watching television
Answer: A
Rationale: Hypoglycemia (55 mg/dL) with diaphoresis is an acute, life-threatening condition
requiring immediate intervention. The client is at risk for seizures, loss of consciousness, and
brain damage if not treated promptly. The nurse should prioritize unstable clients before
stable ones .
Q2. A client with heart failure reports shortness of breath and crackles in the lungs. Which
finding should the nurse report immediately?
A. Heart rate 88 bpm
B. Oxygen saturation 88%
C. Respiratory rate 20/min
D. Blood pressure 130/80 mmHg
Answer: B
Rationale: Low O₂ saturation (88%) indicates hypoxemia requiring immediate intervention.
Normal SpO₂ should be ≥92% for most clients; lower levels suggest inadequate oxygenation
and potential respiratory failure .
Q3. A nurse discovers a fire in a client's room. What is the nurse's first action?
A. Activate the fire alarm
B. Use the fire extinguisher
C. Remove the client from the room
D. Close all doors on the unit
Answer: C
,Rationale: RACE is the priority sequence for fire safety: Rescue (remove clients from
immediate danger), Alarm (activate alarm), Contain (close doors), Extinguish (use
extinguisher). Client safety is always first .
Q4. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assess a surgical incision for signs of infection
B. Feed a client who had a stroke
C. Evaluate the effectiveness of pain medication
D. Teach a client about insulin administration
Answer: B
Rationale: Feeding a stable client is within the UAP scope of practice. Assessment,
evaluation, and teaching require licensed nursing judgment and cannot be delegated .
Q5. A client is refusing a blood transfusion for religious reasons. What is the nurse's best
action?
A. Inform client of risks and document refusal
B. Notify provider and risk manager
C. Ensure refusal is informed, document, and uphold client's right
D. Ask family to persuade the client
Answer: C
Rationale: Clients have the legal right to refuse treatment. The nurse must ensure the
refusal is informed, respect autonomy, document appropriately, and notify the provider .
Q6. A nurse is witnessing informed consent for a procedure. Which action should the
nurse take?
A. Ensure provider explained risks, benefits, alternatives
B. Explain the procedure to the client in detail
C. Sign as witness to client's signature only
D. Verify client was not coerced
Answer: C
Rationale: The nurse's role in informed consent is to witness the client's signature and verify
voluntary consent. The provider is responsible for explaining the procedure .
Q7. Which client is at greatest risk for developing deep vein thrombosis (DVT)?
A. 25-year-old with fractured arm
B. 40-year-old who is mildly obese
C. 65-year-old on bed rest post-hip replacement
D. 60-year-old ambulatory diabetic
,Answer: C
Rationale: Immobility following hip surgery increases venous stasis, leading to clot
formation. Virchow's triad (stasis, hypercoagulability, endothelial damage) is present post-
operatively .
Q8. A client with a new tracheostomy develops sudden respiratory distress. First action?
A. Call respiratory therapy
B. Suction the tracheostomy
C. Assess airway for obstruction
D. Increase oxygen flow rate
Answer: C
Rationale: Airway patency is the priority. The nurse must first assess for obstruction (mucus
plug, displaced tube). Suction or removal of obstruction should follow immediately .
Q9. During a mass casualty event, which client should receive a red tag (immediate)?
A. Client ambulatory with minor abrasions
B. Client not breathing after airway opened
C. Client breathing spontaneously, RR 32/min, palpable radial pulse
D. Client RR 8/min, no radial pulse
Answer: C
Rationale: Respiratory rate >30/min indicates decompensation requiring immediate life-
saving intervention. The client has a chance of survival with rapid treatment .
Q10. A nurse suspects child abuse. Which action should the nurse take?
A. Confront the parents
B. Report findings to school nurse
C. Document objectively and report to CPS
D. Ask child directly if being abused
Answer: C
Rationale: Nurses are mandated reporters of suspected child abuse. The legal duty is to
report to the appropriate agency (CPS), not to investigate .
Q11. A client with a DNR order becomes unresponsive and apneic. What should the nurse
do?
A. Begin chest compressions, call code
B. Call code but do not start compressions
C. Provide comfort measures, support family
D. Ask family if they want DNR honored
, Answer: C
Rationale: A valid DNR order means the client does not wish to receive CPR. The nurse must
honor this order and provide comfort care .
Q12. Which intervention reduces risk of catheter-associated urinary tract infection
(CAUTI)?
A. Change catheter every 24 hours
B. Maintain closed drainage system
C. Irrigate catheter with sterile water daily
D. Hang drainage bag on bed rail
Answer: B
Rationale: Maintaining a closed drainage system minimizes contamination and bacterial
entry, the primary CAUTI prevention strategy .
Q13. A nurse is prioritizing care. Which client should be seen first?
A. COPD client reporting increased shortness of breath
B. Post-appendectomy client requesting pain medication
C. Diabetic client requesting orange juice
D. Client with fractured femur in Buck's traction
Answer: A
Rationale: The ABCs (Airway, Breathing, Circulation) form prioritization. A change in
respiratory status directly threatens airway/breathing and requires immediate assessment .
Q14. A client on warfarin has an INR of 5.8. The nurse should prepare to administer which
antidote?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Flumazenil
Answer: B
Rationale: Vitamin K is the antidote for warfarin (Coumadin) overdose. INR >4.5 with
bleeding risk requires reversal. Protamine sulfate reverses heparin .
Q15. Which action reduces risk of ventilator-associated pneumonia (VAP)?
A. Suction hourly
B. Elevate head of bed 30-45 degrees
C. Change ventilator circuit daily
D. Administer prophylactic antibiotics
EXIT ASSESSMENT 2026 | 180 EXAM QUESTIONS
WITH VERIFIED ANSWERS | FULL RN CONTENT
BREAKDOWN & RATIONALES | ATI NCLEX PREP
PACKAGE
SECTION 1: MANAGEMENT OF CARE & SAFETY
Q1. A nurse receives report on four clients. Which client should be assessed first?
A. Client with diabetes mellitus, blood glucose 55 mg/dL, diaphoretic
B. Client with heart failure, 2+ pitting edema, crackles in lung bases
C. Client post-operative day 1 reporting pain 6/10
D. Client with seizure history watching television
Answer: A
Rationale: Hypoglycemia (55 mg/dL) with diaphoresis is an acute, life-threatening condition
requiring immediate intervention. The client is at risk for seizures, loss of consciousness, and
brain damage if not treated promptly. The nurse should prioritize unstable clients before
stable ones .
Q2. A client with heart failure reports shortness of breath and crackles in the lungs. Which
finding should the nurse report immediately?
A. Heart rate 88 bpm
B. Oxygen saturation 88%
C. Respiratory rate 20/min
D. Blood pressure 130/80 mmHg
Answer: B
Rationale: Low O₂ saturation (88%) indicates hypoxemia requiring immediate intervention.
Normal SpO₂ should be ≥92% for most clients; lower levels suggest inadequate oxygenation
and potential respiratory failure .
Q3. A nurse discovers a fire in a client's room. What is the nurse's first action?
A. Activate the fire alarm
B. Use the fire extinguisher
C. Remove the client from the room
D. Close all doors on the unit
Answer: C
,Rationale: RACE is the priority sequence for fire safety: Rescue (remove clients from
immediate danger), Alarm (activate alarm), Contain (close doors), Extinguish (use
extinguisher). Client safety is always first .
Q4. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assess a surgical incision for signs of infection
B. Feed a client who had a stroke
C. Evaluate the effectiveness of pain medication
D. Teach a client about insulin administration
Answer: B
Rationale: Feeding a stable client is within the UAP scope of practice. Assessment,
evaluation, and teaching require licensed nursing judgment and cannot be delegated .
Q5. A client is refusing a blood transfusion for religious reasons. What is the nurse's best
action?
A. Inform client of risks and document refusal
B. Notify provider and risk manager
C. Ensure refusal is informed, document, and uphold client's right
D. Ask family to persuade the client
Answer: C
Rationale: Clients have the legal right to refuse treatment. The nurse must ensure the
refusal is informed, respect autonomy, document appropriately, and notify the provider .
Q6. A nurse is witnessing informed consent for a procedure. Which action should the
nurse take?
A. Ensure provider explained risks, benefits, alternatives
B. Explain the procedure to the client in detail
C. Sign as witness to client's signature only
D. Verify client was not coerced
Answer: C
Rationale: The nurse's role in informed consent is to witness the client's signature and verify
voluntary consent. The provider is responsible for explaining the procedure .
Q7. Which client is at greatest risk for developing deep vein thrombosis (DVT)?
A. 25-year-old with fractured arm
B. 40-year-old who is mildly obese
C. 65-year-old on bed rest post-hip replacement
D. 60-year-old ambulatory diabetic
,Answer: C
Rationale: Immobility following hip surgery increases venous stasis, leading to clot
formation. Virchow's triad (stasis, hypercoagulability, endothelial damage) is present post-
operatively .
Q8. A client with a new tracheostomy develops sudden respiratory distress. First action?
A. Call respiratory therapy
B. Suction the tracheostomy
C. Assess airway for obstruction
D. Increase oxygen flow rate
Answer: C
Rationale: Airway patency is the priority. The nurse must first assess for obstruction (mucus
plug, displaced tube). Suction or removal of obstruction should follow immediately .
Q9. During a mass casualty event, which client should receive a red tag (immediate)?
A. Client ambulatory with minor abrasions
B. Client not breathing after airway opened
C. Client breathing spontaneously, RR 32/min, palpable radial pulse
D. Client RR 8/min, no radial pulse
Answer: C
Rationale: Respiratory rate >30/min indicates decompensation requiring immediate life-
saving intervention. The client has a chance of survival with rapid treatment .
Q10. A nurse suspects child abuse. Which action should the nurse take?
A. Confront the parents
B. Report findings to school nurse
C. Document objectively and report to CPS
D. Ask child directly if being abused
Answer: C
Rationale: Nurses are mandated reporters of suspected child abuse. The legal duty is to
report to the appropriate agency (CPS), not to investigate .
Q11. A client with a DNR order becomes unresponsive and apneic. What should the nurse
do?
A. Begin chest compressions, call code
B. Call code but do not start compressions
C. Provide comfort measures, support family
D. Ask family if they want DNR honored
, Answer: C
Rationale: A valid DNR order means the client does not wish to receive CPR. The nurse must
honor this order and provide comfort care .
Q12. Which intervention reduces risk of catheter-associated urinary tract infection
(CAUTI)?
A. Change catheter every 24 hours
B. Maintain closed drainage system
C. Irrigate catheter with sterile water daily
D. Hang drainage bag on bed rail
Answer: B
Rationale: Maintaining a closed drainage system minimizes contamination and bacterial
entry, the primary CAUTI prevention strategy .
Q13. A nurse is prioritizing care. Which client should be seen first?
A. COPD client reporting increased shortness of breath
B. Post-appendectomy client requesting pain medication
C. Diabetic client requesting orange juice
D. Client with fractured femur in Buck's traction
Answer: A
Rationale: The ABCs (Airway, Breathing, Circulation) form prioritization. A change in
respiratory status directly threatens airway/breathing and requires immediate assessment .
Q14. A client on warfarin has an INR of 5.8. The nurse should prepare to administer which
antidote?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Flumazenil
Answer: B
Rationale: Vitamin K is the antidote for warfarin (Coumadin) overdose. INR >4.5 with
bleeding risk requires reversal. Protamine sulfate reverses heparin .
Q15. Which action reduces risk of ventilator-associated pneumonia (VAP)?
A. Suction hourly
B. Elevate head of bed 30-45 degrees
C. Change ventilator circuit daily
D. Administer prophylactic antibiotics
